Vietnam Proposes Expanded Health Insurance Coverage for Home Healthcare

Vietnam's Ministry of Health has proposed that health insurance (BHYT) cover costs for over 200 medical services provided by doctors visiting the homes of the elderly, severely disabled, and chronically ill individuals who face difficulties traveling. This proposal is included in a draft circular on BHYT payment for family medicine, home, and remote healthcare, which is currently open for public comment. If enacted, the circular is expected to take effect from January 1, 2027. The draft outlines a list of over 200 technical services that can be performed at home, depending on the specialization and conditions of each healthcare facility. Beyond clinical examinations, patients may receive electrocardiograms (ECG), abdominal, cardiac, vascular, and thyroid ultrasounds, pleural puncture, and endotracheal intubation at home. Sample collection for tests such as blood and urine can also be done at home to aid diagnosis and treatment monitoring. The list also includes many treatment and care techniques typically found in medical facilities, such as injections, infusions, wound care, catheter insertion, oxygen therapy, diabetes patient care, airway foreign body management, circulatory arrest resuscitation, anti-shock treatment, and normal delivery assistance, within permitted professional scopes. Notably, many rehabilitation and long-term care services are also proposed for BHYT coverage. Patients could undergo training for walking, breathing, and swallowing, post-stroke recovery, memory enhancement, and Parkinson's treatment, along with nutritional counseling, assessment, and diet plan development as prescribed by doctors. The draft specifies that home healthcare will apply to seven groups of people who cannot, or have significant difficulty, visiting medical facilities. These include individuals with severe disabilities, the elderly with limited mobility, those with chronic conditions restricting movement, patients requiring palliative care in their final stages of life, and other cases as defined by regulations. Regarding payment, the Ministry of Health proposes that the pricing for home healthcare services be based on current medical facility rates, excluding costs incurred only during in-person visits, such as electricity, water, and reception staff. Instead, the service fee will include travel and labor costs for medical personnel traveling to provide care. Under the proposed mechanism, if the cost of home healthcare does not exceed the rate at a medical facility, BHYT will cover the full amount. If the home service cost is higher, BHYT will pay 50% of the difference, with the patient covering the remaining 50% according to their BHYT benefit level. If approved, this would mark the first time Vietnam establishes a comprehensive BHYT payment mechanism for home healthcare, significantly expanding access to medical services for the elderly, chronically ill, and other vulnerable populations, while also easing the pressure on healthcare facilities.